Recurrent pneumonia among Japanese adults: disease burden and risk factors
In Japan and other societies with rapidly aging populations, recurrent pneumonia (RP) is a major clinical problem yet only limited information exists regarding the burden of this disease. A prospective study of adult pneumonia was conducted to investigate the incidence of RP and potential risk facto...
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| Veröffentlicht in: | BMC pulmonary medicine 2017-01, Vol.17 (1), p.12-12, Article 12 |
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| creator | Ishifuji, Tomoko Sando, Eiichiro Kaneko, Norihiro Suzuki, Motoi Kilgore, Paul E Ariyoshi, Koya Morimoto, Konosuke Hosokawa, Naoto Yaegashi, Makito Aoshima, Masahiro |
| description | In Japan and other societies with rapidly aging populations, recurrent pneumonia (RP) is a major clinical problem yet only limited information exists regarding the burden of this disease.
A prospective study of adult pneumonia was conducted to investigate the incidence of RP and potential risk factors. From February 1, 2012 to January 31, 2013, patients aged ≥ 15 years who were diagnosed with pneumonia were prospectively enrolled in a representative community hospital located in central Japan. Patients were followed for one-year to evaluate the recurrence of pneumonia and characteristics associated with RP. Cox proportional hazards models were constructed to compute adjusted hazard ratios (aHR) and ascertain risk factors significantly associated with RP.
In total, 841 patients with a median age of 73 years (range 15-101 years) were enrolled totaling 1,048 person-years of observation with a median follow-up time of 475 days. A total of 137 patients had at least one recurrent episode with an incidence rate of 13.1 per 100 person-years (95% confidence interval: 11.1-15.5). In multivariate analysis, a past history of pneumonia (aHR 1.95, 95% CI: 1.35-2.8), chronic pulmonary disease (aHR 1.86, 1.24-2.78) and inhaled corticosteroid usage (aHR 1.78, 1.12-2.84) and hypnotic/sedative medication usage (aHR 2.06, 1.28-3.31) were identified as independent risk factors for recurrent pneumonia, whereas angiotensin converting enzyme-inhibitors usage was associated with a reduction of the risk of RP (aHR 0.22, 0.05-0.91). The detection of P. aeruginosa was significantly associated with RP even after adjusting for chronic pulmonary diseases (aHR = 2.37).
Recurrent pneumonia constitutes a considerable proportion of the pneumonia burden in Japan. A past history of pneumonia, chronic pulmonary disease, inhaled corticosteroid and hypnotic/sedative medication usage and detection of P. aeruginosa were identified as independent risk factors for recurrent pneumonia and special attention regarding the use of medications in this vulnerable population is needed to reduce the impact of this disease in aging populations. |
| doi_str_mv | 10.1186/s12890-016-0359-1 |
| format | Article |
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A prospective study of adult pneumonia was conducted to investigate the incidence of RP and potential risk factors. From February 1, 2012 to January 31, 2013, patients aged ≥ 15 years who were diagnosed with pneumonia were prospectively enrolled in a representative community hospital located in central Japan. Patients were followed for one-year to evaluate the recurrence of pneumonia and characteristics associated with RP. Cox proportional hazards models were constructed to compute adjusted hazard ratios (aHR) and ascertain risk factors significantly associated with RP.
In total, 841 patients with a median age of 73 years (range 15-101 years) were enrolled totaling 1,048 person-years of observation with a median follow-up time of 475 days. A total of 137 patients had at least one recurrent episode with an incidence rate of 13.1 per 100 person-years (95% confidence interval: 11.1-15.5). In multivariate analysis, a past history of pneumonia (aHR 1.95, 95% CI: 1.35-2.8), chronic pulmonary disease (aHR 1.86, 1.24-2.78) and inhaled corticosteroid usage (aHR 1.78, 1.12-2.84) and hypnotic/sedative medication usage (aHR 2.06, 1.28-3.31) were identified as independent risk factors for recurrent pneumonia, whereas angiotensin converting enzyme-inhibitors usage was associated with a reduction of the risk of RP (aHR 0.22, 0.05-0.91). The detection of P. aeruginosa was significantly associated with RP even after adjusting for chronic pulmonary diseases (aHR = 2.37).
Recurrent pneumonia constitutes a considerable proportion of the pneumonia burden in Japan. A past history of pneumonia, chronic pulmonary disease, inhaled corticosteroid and hypnotic/sedative medication usage and detection of P. aeruginosa were identified as independent risk factors for recurrent pneumonia and special attention regarding the use of medications in this vulnerable population is needed to reduce the impact of this disease in aging populations.</description><identifier>ISSN: 1471-2466</identifier><identifier>EISSN: 1471-2466</identifier><identifier>DOI: 10.1186/s12890-016-0359-1</identifier><identifier>PMID: 28077107</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Adolescent ; Adrenal Cortex Hormones - administration & dosage ; Adult ; Aged ; Aged, 80 and over ; Bacterial pneumonia ; Community-Acquired Infections - epidemiology ; Comorbidity ; Cost of Illness ; Diseases ; Female ; Humans ; Hypnotics and Sedatives - therapeutic use ; Incidence ; Japan - epidemiology ; Male ; Middle Aged ; Multivariate Analysis ; Pneumonia ; Pneumonia, Bacterial - epidemiology ; Prevalence studies (Epidemiology) ; Prospective Studies ; Pseudomonas aeruginosa ; Pulmonary Disease, Chronic Obstructive - epidemiology ; Pulmonology ; Recurrence ; Relapse ; Risk Factors ; Sputum - microbiology ; Statistics ; Survival Analysis ; Urine - microbiology ; Young Adult</subject><ispartof>BMC pulmonary medicine, 2017-01, Vol.17 (1), p.12-12, Article 12</ispartof><rights>COPYRIGHT 2017 BioMed Central Ltd.</rights><rights>Copyright BioMed Central 2017</rights><rights>The Author(s). 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c578t-4c6bc425caaeeae8b7b787c3b5903c41cc751200dd1e6e4315ee2071180039b63</citedby><cites>FETCH-LOGICAL-c578t-4c6bc425caaeeae8b7b787c3b5903c41cc751200dd1e6e4315ee2071180039b63</cites><orcidid>0000-0003-2912-9919</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225545/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225545/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28077107$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ishifuji, Tomoko</creatorcontrib><creatorcontrib>Sando, Eiichiro</creatorcontrib><creatorcontrib>Kaneko, Norihiro</creatorcontrib><creatorcontrib>Suzuki, Motoi</creatorcontrib><creatorcontrib>Kilgore, Paul E</creatorcontrib><creatorcontrib>Ariyoshi, Koya</creatorcontrib><creatorcontrib>Morimoto, Konosuke</creatorcontrib><creatorcontrib>Hosokawa, Naoto</creatorcontrib><creatorcontrib>Yaegashi, Makito</creatorcontrib><creatorcontrib>Aoshima, Masahiro</creatorcontrib><creatorcontrib>Adult Pneumonia Study Group - Japan (APSG-J)</creatorcontrib><creatorcontrib>on behalf of the Adult Pneumonia Study Group - Japan (APSG-J)</creatorcontrib><title>Recurrent pneumonia among Japanese adults: disease burden and risk factors</title><title>BMC pulmonary medicine</title><addtitle>BMC Pulm Med</addtitle><description>In Japan and other societies with rapidly aging populations, recurrent pneumonia (RP) is a major clinical problem yet only limited information exists regarding the burden of this disease.
A prospective study of adult pneumonia was conducted to investigate the incidence of RP and potential risk factors. From February 1, 2012 to January 31, 2013, patients aged ≥ 15 years who were diagnosed with pneumonia were prospectively enrolled in a representative community hospital located in central Japan. Patients were followed for one-year to evaluate the recurrence of pneumonia and characteristics associated with RP. Cox proportional hazards models were constructed to compute adjusted hazard ratios (aHR) and ascertain risk factors significantly associated with RP.
In total, 841 patients with a median age of 73 years (range 15-101 years) were enrolled totaling 1,048 person-years of observation with a median follow-up time of 475 days. A total of 137 patients had at least one recurrent episode with an incidence rate of 13.1 per 100 person-years (95% confidence interval: 11.1-15.5). In multivariate analysis, a past history of pneumonia (aHR 1.95, 95% CI: 1.35-2.8), chronic pulmonary disease (aHR 1.86, 1.24-2.78) and inhaled corticosteroid usage (aHR 1.78, 1.12-2.84) and hypnotic/sedative medication usage (aHR 2.06, 1.28-3.31) were identified as independent risk factors for recurrent pneumonia, whereas angiotensin converting enzyme-inhibitors usage was associated with a reduction of the risk of RP (aHR 0.22, 0.05-0.91). The detection of P. aeruginosa was significantly associated with RP even after adjusting for chronic pulmonary diseases (aHR = 2.37).
Recurrent pneumonia constitutes a considerable proportion of the pneumonia burden in Japan. A past history of pneumonia, chronic pulmonary disease, inhaled corticosteroid and hypnotic/sedative medication usage and detection of P. aeruginosa were identified as independent risk factors for recurrent pneumonia and special attention regarding the use of medications in this vulnerable population is needed to reduce the impact of this disease in aging populations.</description><subject>Adolescent</subject><subject>Adrenal Cortex Hormones - administration & dosage</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bacterial pneumonia</subject><subject>Community-Acquired Infections - epidemiology</subject><subject>Comorbidity</subject><subject>Cost of Illness</subject><subject>Diseases</subject><subject>Female</subject><subject>Humans</subject><subject>Hypnotics and Sedatives - therapeutic use</subject><subject>Incidence</subject><subject>Japan - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Pneumonia</subject><subject>Pneumonia, Bacterial - epidemiology</subject><subject>Prevalence studies (Epidemiology)</subject><subject>Prospective Studies</subject><subject>Pseudomonas aeruginosa</subject><subject>Pulmonary Disease, Chronic Obstructive - epidemiology</subject><subject>Pulmonology</subject><subject>Recurrence</subject><subject>Relapse</subject><subject>Risk Factors</subject><subject>Sputum - microbiology</subject><subject>Statistics</subject><subject>Survival Analysis</subject><subject>Urine - microbiology</subject><subject>Young Adult</subject><issn>1471-2466</issn><issn>1471-2466</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNptUk1rFTEUDaLYWv0BbmTAjZtpc_M9LoRS_CqFQtF1yGTuPFNnkmcyU_Dfm8ertS2Sxc3HOSc5N4eQ10CPAYw6KcBMR1sKqqVcdi08IYcgNLRMKPX03vyAvCjlmlLQRvLn5IAZqjVQfUjOr9CvOWNcmm3EdU4xuMbVsmnO3dZFLNi4YZ2W8r4ZQkFX1_2aB4yNi0OTQ_nZjM4vKZeX5NnopoKvbusR-f7p47ezL-3F5eevZ6cXrZfaLK3wqveCSe8cokPT614b7XkvO8q9AO-1BEbpMAAqFBwkIqO6GqaUd73iR-TDXne79jMOvr49u8luc5hd_m2TC_bhSQw_7CbdWMmYlEJWgXe3Ajn9WrEsdg7F4zRVu2ktFow0QI0EXqFvH0Gv05pjtVdRinfC1E7-Q23chDbEMdV7_U7UngqtWRVSoqKO_4OqY8A5-BRxDHX_AQH2BJ9TKRnHO49A7S4Adh8AWwNgdwGwUDlv7jfnjvH3x_kfBSaqTw</recordid><startdate>20170111</startdate><enddate>20170111</enddate><creator>Ishifuji, Tomoko</creator><creator>Sando, Eiichiro</creator><creator>Kaneko, Norihiro</creator><creator>Suzuki, Motoi</creator><creator>Kilgore, Paul E</creator><creator>Ariyoshi, Koya</creator><creator>Morimoto, Konosuke</creator><creator>Hosokawa, Naoto</creator><creator>Yaegashi, Makito</creator><creator>Aoshima, Masahiro</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2912-9919</orcidid></search><sort><creationdate>20170111</creationdate><title>Recurrent pneumonia among Japanese adults: disease burden and risk factors</title><author>Ishifuji, Tomoko ; Sando, Eiichiro ; Kaneko, Norihiro ; Suzuki, Motoi ; Kilgore, Paul E ; Ariyoshi, Koya ; Morimoto, Konosuke ; Hosokawa, Naoto ; Yaegashi, Makito ; Aoshima, Masahiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c578t-4c6bc425caaeeae8b7b787c3b5903c41cc751200dd1e6e4315ee2071180039b63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adrenal Cortex Hormones - administration & dosage</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bacterial pneumonia</topic><topic>Community-Acquired Infections - epidemiology</topic><topic>Comorbidity</topic><topic>Cost of Illness</topic><topic>Diseases</topic><topic>Female</topic><topic>Humans</topic><topic>Hypnotics and Sedatives - therapeutic use</topic><topic>Incidence</topic><topic>Japan - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Pneumonia</topic><topic>Pneumonia, Bacterial - epidemiology</topic><topic>Prevalence studies (Epidemiology)</topic><topic>Prospective Studies</topic><topic>Pseudomonas aeruginosa</topic><topic>Pulmonary Disease, Chronic Obstructive - epidemiology</topic><topic>Pulmonology</topic><topic>Recurrence</topic><topic>Relapse</topic><topic>Risk Factors</topic><topic>Sputum - microbiology</topic><topic>Statistics</topic><topic>Survival Analysis</topic><topic>Urine - microbiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ishifuji, Tomoko</creatorcontrib><creatorcontrib>Sando, Eiichiro</creatorcontrib><creatorcontrib>Kaneko, Norihiro</creatorcontrib><creatorcontrib>Suzuki, Motoi</creatorcontrib><creatorcontrib>Kilgore, Paul E</creatorcontrib><creatorcontrib>Ariyoshi, Koya</creatorcontrib><creatorcontrib>Morimoto, Konosuke</creatorcontrib><creatorcontrib>Hosokawa, Naoto</creatorcontrib><creatorcontrib>Yaegashi, Makito</creatorcontrib><creatorcontrib>Aoshima, Masahiro</creatorcontrib><creatorcontrib>Adult Pneumonia Study Group - Japan (APSG-J)</creatorcontrib><creatorcontrib>on behalf of the Adult Pneumonia Study Group - Japan (APSG-J)</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMC pulmonary medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ishifuji, Tomoko</au><au>Sando, Eiichiro</au><au>Kaneko, Norihiro</au><au>Suzuki, Motoi</au><au>Kilgore, Paul E</au><au>Ariyoshi, Koya</au><au>Morimoto, Konosuke</au><au>Hosokawa, Naoto</au><au>Yaegashi, Makito</au><au>Aoshima, Masahiro</au><aucorp>Adult Pneumonia Study Group - Japan (APSG-J)</aucorp><aucorp>on behalf of the Adult Pneumonia Study Group - Japan (APSG-J)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Recurrent pneumonia among Japanese adults: disease burden and risk factors</atitle><jtitle>BMC pulmonary medicine</jtitle><addtitle>BMC Pulm Med</addtitle><date>2017-01-11</date><risdate>2017</risdate><volume>17</volume><issue>1</issue><spage>12</spage><epage>12</epage><pages>12-12</pages><artnum>12</artnum><issn>1471-2466</issn><eissn>1471-2466</eissn><abstract>In Japan and other societies with rapidly aging populations, recurrent pneumonia (RP) is a major clinical problem yet only limited information exists regarding the burden of this disease.
A prospective study of adult pneumonia was conducted to investigate the incidence of RP and potential risk factors. From February 1, 2012 to January 31, 2013, patients aged ≥ 15 years who were diagnosed with pneumonia were prospectively enrolled in a representative community hospital located in central Japan. Patients were followed for one-year to evaluate the recurrence of pneumonia and characteristics associated with RP. Cox proportional hazards models were constructed to compute adjusted hazard ratios (aHR) and ascertain risk factors significantly associated with RP.
In total, 841 patients with a median age of 73 years (range 15-101 years) were enrolled totaling 1,048 person-years of observation with a median follow-up time of 475 days. A total of 137 patients had at least one recurrent episode with an incidence rate of 13.1 per 100 person-years (95% confidence interval: 11.1-15.5). In multivariate analysis, a past history of pneumonia (aHR 1.95, 95% CI: 1.35-2.8), chronic pulmonary disease (aHR 1.86, 1.24-2.78) and inhaled corticosteroid usage (aHR 1.78, 1.12-2.84) and hypnotic/sedative medication usage (aHR 2.06, 1.28-3.31) were identified as independent risk factors for recurrent pneumonia, whereas angiotensin converting enzyme-inhibitors usage was associated with a reduction of the risk of RP (aHR 0.22, 0.05-0.91). The detection of P. aeruginosa was significantly associated with RP even after adjusting for chronic pulmonary diseases (aHR = 2.37).
Recurrent pneumonia constitutes a considerable proportion of the pneumonia burden in Japan. A past history of pneumonia, chronic pulmonary disease, inhaled corticosteroid and hypnotic/sedative medication usage and detection of P. aeruginosa were identified as independent risk factors for recurrent pneumonia and special attention regarding the use of medications in this vulnerable population is needed to reduce the impact of this disease in aging populations.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>28077107</pmid><doi>10.1186/s12890-016-0359-1</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0003-2912-9919</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adrenal Cortex Hormones - administration & dosage Adult Aged Aged, 80 and over Bacterial pneumonia Community-Acquired Infections - epidemiology Comorbidity Cost of Illness Diseases Female Humans Hypnotics and Sedatives - therapeutic use Incidence Japan - epidemiology Male Middle Aged Multivariate Analysis Pneumonia Pneumonia, Bacterial - epidemiology Prevalence studies (Epidemiology) Prospective Studies Pseudomonas aeruginosa Pulmonary Disease, Chronic Obstructive - epidemiology Pulmonology Recurrence Relapse Risk Factors Sputum - microbiology Statistics Survival Analysis Urine - microbiology Young Adult |
| title | Recurrent pneumonia among Japanese adults: disease burden and risk factors |
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